It is disappointing that the Cass Review will not, overall, accomplish its stated goals of ensuring a high standard of care for young people who need gender identity support and instead pulls the UK further from international best practices.
TransActual welcomes the Report’s starting principle that trans children need high quality, holistic, personal and timely care which meets their needs. We welcome the call that medical practice in this area should be of high quality and not one-size-fits all.
However, we are concerned about the amount of clinical evidence that was discarded and attempts to discredit international bodies, as well as an apparent disregard for medical ethics.
The thing that matters most to trans children and young people will be how NHS England decides to respond to the Report. We have a number of concerns in relation to that.
NHS Specialist Commissioning, on the recommendation of the Cass Review, have already acted to change the planned timescales for the review of the adult gender dysphoria service specification and to announce a review into the provision of adult gender dysphoria services. This was not an outcome that we anticipated, given that adult services were not within the remit of the review. As unexpected as this news is, it is important to note that no changes have yet been proposed in relation to adult services.
The easy and cheap recommendations within the Cass Review are likely to be harmful, while the work needed to improve the NHS offer will take time and money. We urge NHS England not just to implement the easy and cheap recommendations. We also urge the media to report accurately and sensitively, and not fall for the misrepresentations which are likely to be rife.
This news will be hard to hear for many trans people. We wish to offer trans people of all ages the reassurance that we and many others are working for a world where trans people can live safely, with dignity and with appropriate access to healthcare.